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How reliable is visual assessment of the electrically elicited stapedius reflex threshold during cochlear implant surgery, compared with tympanometry?

Published online by Cambridge University Press:  05 November 2010

H W Pau*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
K Ehrt
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
T Just
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
U Sievert
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
R Dahl
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Germany
*
Address for correspondence: Prof Dr Hans Wilhelm Pau, Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Doberaner Str 137–139, 18057 Rostock, Germany Fax: +49 (0)381 494 8302 E-mail: hans-wilhelm.pau@med.uni-rostock.de

Abstract

Objectives:

To assess the reliability of visually assessed thresholds of the electrically elicited stapedius reflex, recorded during cochlear implant surgery, compared with intra-operative tympanometric threshold assessment. Intra-operatively recorded electrically elicited stapedius reflex thresholds vary considerably, and differ from those measured post-operatively by means of impedance changes (i.e. using tympanometry). Thus, any confounding effect of different intra-operative techniques and visual assessment inaccuracies should be excluded.

Methods:

Both techniques (i.e. visual observation and tympanometry) were performed intra-operatively in six patients, and threshold values were compared.

Results:

Recorded electrically elicited stapedius reflex thresholds were very similar for both techniques. Visually assessed thresholds were slightly higher in some cases and lower in others, compared with tympanometric thresholds.

Discussion:

There was almost no difference between reflex thresholds measured with the two different techniques under the same intra-operative conditions. Therefore, we conclude that differences between intra- and post-operative thresholds are not due to the use of different measuring techniques. The main reason for such differences is probably the influence of intra-operative narcotics on reflex thresholds.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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